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Correlation between Late Cord Clamping and Phototherapy and Other neonatal Unfavorable Outcomes: A Randomized Clinical Trial

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Open Journal of Obstetrics and Gynecology 2022年第3期12卷 193-200页

作者： Janete Vettorazzi Gabriela Françoes Rostirolla Maria Alexandrina Zanatta Edimárlei Gonsales Valério Charles Francisco Ferreira Jose Geraldo Lopes Ramos Postgraduation Program in Health Sciences: Gynecology and Obstetrics Universidade Federal do Rio Grande do Sul (UFRGS) Porto Alegre Brazil Department of Gynecology and Obstetrics Faculty of Medicine (FAMED) Universidade Federal do Rio Grande do Sul (UFRGS) Porto Alegre Brazil Department of Gynecology and Obstetrics Faculty of Medicine (FAMED) Universidade Federal do Rio Grande do Sul (UFRGS) Porto Alegre Brazil Department of Gynecology and Obstetrics Faculty of Medicine Universidade de Caxias do Sul (UCS)

Background: Recently, late umbilical cord clamping is generally recommended, which decreases neonatal anemia;however, it may also increase neonatal jaundice and some other poor outcomes. Objectives: We here attempted to determine whether late clamping actually increases the incidence of phototherapy for jaundice and other poor outcomes of the term “low-risk newborns”. Methods: With the approval of the Brazilian Registry of Clinical Trials (REBEC), a total of 357 low-risk newborns (singleton, uncomplicated pregnancy/delivery, in a Brazilian public institution) were randomized into two groups: group I (n = 114): cord clamping 1 minute (early clamping) or group II (n = 243): cord clamping between 1 - 3 minutes (late clamping). Statistics were used appropriately (i.e., measures of central tendency, dispersion for continuous variables, Shapiro-Wilk, Mann-Whitney test, or Chi-square test). Results: Phototherapy was performed in 5.3% in both groups. Also, there were no statistical differences in the occurrence of secondary outcomes, such as sepsis, neonatal ICU admission, and transient tachypnea of the newborns: i.e., 0.9%, 15.8%, and 3.5%, respectively for group I versus 1.2%, 15.6%, and 5.8%, respectively for group II. Conclusion: Late umbilical cord clamping does not increase the need for phototherapy in low-risk neonates. This result corroborates the current recommendation of late cord clamping, whenever appropriate.

关键词： Phototherapy neonatal Anemia neonatal jaundice Late Cord Clamping

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Early vs. Delayed Cord Clamping at Full-Term Planned Cesarean Section: A Randomized Study

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Open Journal of Obstetrics and Gynecology 2021年第6期11卷 647-653页

作者： K. Morales-Allard C. Montufar-Rueda S. Gomez-Manrique Department of Obstetrics and Gynecology Complejo Hospitalario Dr. Arnulfo Arias M. CSS Panama City Panama Critical Care Obstetrics Unit Department of Obstetrics and Gynecology Complejo Hospitalario Dr. Arnulfo Arias M. CSS Panama City Panama neonatal Intensive Care Unit Complejo Hospitalario Dr. Arnulfo Arias M. CSS Panama City Panama

Objective: In cesarean section (CS), which, early vs. delayed cord clamping is better for neonatal and maternal hematocrit/hemoglobin level is not yet completely determined. This randomized controlled study attempted to determine this issue. Methods: Study population consisted of 64 full-term pregnant women/neonates undergoing planned CS: 32 received early cord clamping (ECC: 15 seconds after birth) and 32 delayed cord clamping (DCC: 90 seconds). We measured and analyzed 1) neonatal hematocrit at the first 24 - 48 hours, and 2) maternal-hemoglobin-change before and after CS.

关键词： Umbilical Cord Clamping Elective Cesarean Section neonatal Hematocrit neonatal jaundice Obstetric Hemorrhage

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